# CENTRAL COAST URGENT CARE MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Central Coast Urgent Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891840088
- **Authorized official:** DR. THOMAS A CARUSO MD (PHYSICIAN PARTNER)
- **Authorized official phone:** (805) 922-0561

## Contact information

- **Practice address:** 340 EAST BETTERAVIA RD, SUITE C, SANTA MARIA, CA 93454-7847
- **Practice address phone:** (805) 922-0561
- **Practice address fax:** (805) 922-0083
- **Mailing address:** PO BOX 848722, BOSTON, MA 02284-8722
- **Mailing address phone:** (805) 922-0561
- **Mailing address fax:** (805) 922-0083

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 06/17/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1083643878 | NPI | CA |
| 01 | — | 1245327840 | NPI | CA |
| 01 | — | 1376510529 | NPI | CA |
| 01 | — | 1437246022 | NPI | CA |
| 01 | — | 1609965433 | NPI | CA |
| 01 | — | 1891840088 | NPI | CA |
| 01 | — | W8259 | MEDICARE GROUP ID | CA |
| 01 | — | WA50123B | MEDICARE PPIN | CA |
| 01 | — | WG32607A | MEDICARE PPIN | CA |
| 01 | — | WG48284A | MEDICARE PPIN | CA |
| 01 | — | WG61780E | MEDICARE PPIN | CA |
| 01 | — | WPT10965B | MEDICARE PPIN | CA |
| 01 | — | WPT8518A | MEDICARE PPIN | CA |
| 01 | — | ZZZ16208Z | BLUE SHIELD | CA |